Provider Demographics
NPI:1750678900
Name:MABEE, MELINDA K (PAC)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:K
Last Name:MABEE
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:K
Other - Last Name:HUMEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PAC
Mailing Address - Street 1:2055 N HIGH ST STE 130
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-5504
Mailing Address - Country:US
Mailing Address - Phone:303-861-2663
Mailing Address - Fax:303-861-4741
Practice Address - Street 1:2055 N HIGH ST STE 130
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-5504
Practice Address - Country:US
Practice Address - Phone:303-861-2663
Practice Address - Fax:303-861-4741
Is Sole Proprietor?:No
Enumeration Date:2011-07-07
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0007861363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ626556Medicaid
AZ626556Medicaid